A nurse practitioner-driven palliative care intervention improves cancer patients' quality of life

May 18, 2012

Recent studies have shown that palliative care interventions aimed at addressing patients' emotional, spiritual and social needs have a significant impact on cancer patients' quality of life and may even improve cancer patients' overall survival. Despite this, most cancer patients being cared for in their communities do not have access to these services.

Most also do not have addressed and are not aware of the benefits of hospice services. In order to address this issue, researchers at in Florida decided to test whether a nurse practitioner-driven consultation that used quality-of-life assessment tools and advance directives tools resulted in improvement in the cancer patients' quality of life.

The researchers, who published their findings online in the Journal of Palliative Medicine, say their study suggests that a consultative visit between a nurse practitioner and a metastatic cancer patient goes a long way to improving that patient's emotional and mental well-being.

The study results were strongly positive despite the fact that only 26 patients were enrolled. A total of 100 had been planned but accrual to the study was halted when other recently completed randomized studies had shown the benefit of similar nurse driven palliative interventions. Patients also frequently refused to enroll if they were randomized to the "control" arm, which did not include a discussion with an oncology advanced registered nurse practitioner about advance directives and how their symptoms could best be managed. The 12 patients who did receive intervention from a nurse had a significant improvement in their , compared to the 14 patients in the control arm.

"The findings should be extremely helpful to oncologists in both community and academic concerned about how to incorporate palliative care, including discussions about advance directives in the outpatient management of their cancer patients," says the study's senior investigator, Gerardo Colon-Otero, M.D., an oncologist in the Division of Hematology/Oncology at Mayo Clinic in Florida.

The study also demonstrates that oncology clinics are not doing enough to help improve their patients' quality of life because they are so focused on treating the cancer. As a result, there are missed opportunities to provide additional support and many patients end up enrolling in hospice care much too late and do not have advance directives completed in a timely fashion.

"This study suggests that we shouldn't be afraid of these discussions, and that many of our patients actually welcome having advance directives and hearing about hospice services," Dr. Colon-Otero says. "This relatively simple strategy of having a trained in palliative care and embedded within the oncology clinic to provide these consultation services is helpful, all the way around."

Based on the study findings, Dr. Colon-Otero and his colleagues at the Florida Society of Clinical Oncology received a grant from the American Society of Clinical Oncology (ASCO) to disseminate this program in Florida. As part of this grant, 13 nurse practitioners from both public and private cancer clinics throughout the state were trained at Mayo Clinic in Jacksonville in providing end- of-life counseling and symptom management to patients. "This could be a model that many oncology practices can follow to bring and advance directives discussions to their cancer patients," he says.

Explore further: Michigan cancer programs follow care guidelines for common cancers, study finds

Related Stories

Michigan cancer programs follow care guidelines for common cancers, study finds

April 10, 2012
A majority of Michigan oncology practices participating in a statewide consortium followed treatment guidelines for common cancers, but had gaps in managing symptoms and end-of-life care, according to a new study.

FATE results prove to be useful in end-of-life care

May 2, 2011
Though there have been significant improvements in the treatment of head and neck cancer, there is still a lack of data on the experience of end of life care for head and neck cancer patients, according to a new study published ...

Advance directives related to use of palliative care, lower Medicare end-of-life spending

October 4, 2011
Advance directives do have an impact on health care at the end of life, especially in regions of the country with high spending on end-of-life care, according to a University of Michigan study.

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.